This post is related to the prior one, “It’s About Time” where I talk about the process of choosing myself and my needs above the system. I wrote this post to share a different aspect of my story at the request of a dear friend and all around smart guy. Addam Driver is a software engineer, musician, real estate mogul and expert in buying his time back. He writes about this and other insights at http://www.buymytimeback.com

It’s been quite some time since I’ve written. In all honesty, I’ve been contemplating what to write about, and what would helpful to students. I’ve been spending time concentrating on being a good physician, wife, mother and adjusting to life changes.

During the early part of my blogging, I moved and transitioned my family back to our original home. It took a lot of sacrifices and required me to not only quit my job, but to decide to leave a less than ideal situation in order to do so. Things appeared not quite right early on, but I stayed in order to keep the peace for my family’s sake. Eventually, the toxic environment took a toll on my health and well being, and I would argue that of my family as well. This year, I decided it was about time to put myself and my family first.

This meant that I had to have the courage to leave a seemingly cush, coveted job that was “comfortable” with guaranteed salary and choose one in which I was paid only when I worked. I gave up benefits, pensions and loads of “stability”. What I traded it for was my sanity and my freedom. I needed an environment where I was free to be creative in other pursuits and where I was not tolerated, but celebrated. This was not without sacrifice. I gave up so much, and I had to re-immerse myself in my core specialty of anesthesiology. I was practicing pain medicine for the prior 2-3 years, and yes, this is a different specialty entirely. It involves clinic, continuity of care and procedures that you need specialized training to do. I enjoyed this work and the training, but the environment just wasn’t right for me.

After I left, I joined a group that provides intra-operative anesthesia services. I hadn’t worked in this capacity for a couple of years and jumping over this hurdle seemed like I was scaling Mt. Everest! With a supportive boss and fantastic colleagues, I was able to bridge this seemingly unsurmountable gap and become an OR anesthesiologist once again. It never left, but truly it was like riding a bike.

I did this for myself, my sanity, and my family. We needed to move back home and my job environment was truly toxic for me. I had to choose life and choose myself. This took grit and sacrifice, but so far it has been well worth it. I tell this story from the perspective of what it is like to be a physician and the realities. Even as an attending physician, you still have to find your place and the right fit for your career and interests.

What are the takeaways from my story? There are several –

Don’t be afraid to choose yourself. Your profession will be there, but if you aren’t ok, you won’t be. Make decisions based on your core beliefs and those that serve your needs. When you are in training, this can be difficult to do. Don’t forget to seek help and especially mental health services.

Training in a subspecialty gives flexibility. In anesthesiology, pain medicine gives the option for work in the procedure suite, the clinic, or in the operating room as well. Research is also another way to add dimension to your specialty and to your work. There are academic positions, private practice opportunities and jobs at large conglomerates. Do your research and consider what environment is best for you.

Whenever there is transition or change, there is sacrifice involved. Sometimes this requires courage, doing some things that are uncomfortable and there is definitely a period of transition. Give yourself grace to adjust.

If something is wrong, admit it. Don’t simply stay in a job because you need to pay your bills or because you have to. Save up, prepare yourself and make plans to transition. You owe it to yourself to be happy, healthy and whole.

I hope sharing my story helps some of you out there realize that there is light at the end of the tunnel. One day, you will be able to make these types of decisions. Being a physician gives you the freedom to choose and to change. I can be an independent contractor, own a business, be a consultant and do many things that feed my soul. Don’t listen to those who say it doesn’t get better than medical school or residency. It does get better. When you have the chance to make career decisions, make sure you choose for yourself and get informed about your options. It’s important to choose for yourself and your own wellness.

I hope your day is going well. Mine is. I’m spending it with my family and contemplating what I’d want to know if I were in your shoes. I was there once and felt that getting into medical school was impossible. I felt as if no matter how high my scores were or my grades, I could never measure up.

The fact is the medical school admissions process is getting more stringent. That’s right – its getting harder. Now more than ever before. some schools are requiring higher GPAs – 3.4 and above and high MCAT scores (> 85th percentile). This is higher than previous times and makes it much harder for students to qualify. Not all schools have adopted these criterion – so don’t fret. All is not lost. I just want you all to be apprised to what is required, so you can improve your grades and scores accordingly.

If I were in your shoes, I’d take longer to do my post bac or retake coursework and I’d study longer for the MCAT with a prep course to ensure I make these scores. The average MCAT score for African American applicants is near 496 and average MCAT for African American matriculants is 504 which is 61st percentile. Latino applicants have average GPA 3.4 and average MCAT of 499. Latino matriculants have average GPA 3.6 and average MCAT score of 505.

Having an score of 85th percentile on the MCAT is near 512, which may prove difficult to achieve for students underrepresented in medicine.The reasons are multifactorial. including not having money for a prep course, having to work in order to support oneself and other matters. My concern is that with having these criterion, certain schools will become less diverse in terms of ethnicity and be robbed of a perspective that comes with having a diverse student body.

So premeds. please be advised some schools have these higher criterion. At a minimum in my opinion, to apply to medical school, you need at least a 3.2 GPA and MCAT score of 75% percentile. This seems low, but for some students who are disadvantaged and don’t have the same resources as others, I’d say these are absolute minimum numbers and you MUST apply to many schools (25-30).

Please feel free to contact me with any questions. Just trying to give you all a heads up.

I hope I’m not the bearer of bad news, but I do believe its better to know now vs. not preparing well.

Interview Season is here! It’s such an exciting time. It’s the time to show the medical school or residency program of your choice that YOU belong there. You landed the interview, they’ve seen your file, your writing, your motivation for medicine. So now you get the chance to sell it! But how do you do this? First- let me share some of my experiences with you.

When I was a premed student like many of you, I doubted myself and my ability to be a physician, let alone a good one. I didn’t feel I belonged in my undergrad science courses at UC Berkeley, let alone in medical school. So – how did I go about mustering up the courage to stare Dean’s of admissions in the face and tell them – I’m the one you want, I belong here and I can contribute something to your class? The honest answer is I’m not entirely sure, but I know that I wanted it so badly. I came so far, I invested so much and I was not going to let anything stop me from achieving my goal, including fear.

I employed a number of strategies that I found worked for me, and I want to share them with you. These also apply to residency interviews as well, so medical students, don’t check out. 🙂

1. I prepared for my first interview well as a template for the rest of my interviews.

What does this mean? I looked up the Dean of Admission and Assistant Dean, their specialties and major research areas in the medical school. I rehearsed speaking out loud at a mirror stating why I wanted to pursue medicine and what it is about the school in particular that made me want to study there. I took care to wear a black, conservative suit and pearls. I did everything I could think of. I arrived, and I can pretty much say my interview day was anything but successful. I remember being asked why I wanted to attend there, why would I come there, and when I gave answers, I was simply grilled further. I was asked to design a research study on the fly. This threw me for a loop as I hadn’t given thought about this before. I tried my best but I knew I was floundering in both my interviews. Finally, the one of the Deans of Admission used a term that I interpreted as harkening to the Old South and slavery. For me, this was the last straw. I instantly knew this place was not for me, no matter how badly I wanted to attend medical school.

So what was that? A failure? A flop? No. It was practice. Yes, I used this first interview to get the kinks out, to learn how to think on the fly and to answer unanticipated questions to the best of my ability. I realized that if an interviewer was hell bent to seeing me in a negative light, all I can do is present my best self – that is all. So in each subsequent interview, I did just that. I learned from the first one, devised a sample research study based on my prior work, knew my research projects inside out and was able to discuss them in detail and shored up those weak areas so that I shined on subsequent interviews.

2. I want to say that I rested well, took care of myself and all those things. It’s just not true. I was a tragedy mess on my medical school and residency interview trail. I was on flights, in and out of airports and walked in New York once so far in high heels I had a blood blister on my foot the whole interview day. I’m confessing this because I don’t want you to do this. Don’t walk through New York crying because you didn’t bring the right shoes. Wear tennis shoes with your suit and change a block away. Bring a purse big enough to house said shoes. Bring a nice portfolio with you to carry around with you. Bring extra deodorant, mints, pins for your hair etc. Believe it or not, these simple things can help allay the stress and anxiety that comes from preparing for one of the biggest days that determines your admissions status to medical school or residency. If you are rested, calm and collected, that goes a long way. I also must stress to SMILE even if you are not a people person. Smile at the staff, greet the front desk people, shake hands, look them in the eye. DON’T look down at your phone continually. Be a human being and be polite to everyone. This helps believe it or not. The admission staff have very much pull in this process. If you are rude to them over the phone or in person, especially on interview day, this could ruin your chances of admission or matching.

3. I made sure to let my first choice institution know that I would go there above any and all schools. Interestingly I don’t remember my medical school interview at UCLA. I do remember my residency one, and I embarrassingly messed up on a question I knew the answer to with a faculty member I knew. I was scared. It happens. I tried my best to recover. I another interview with the Chair of Anesthesiology, I asked her how she trailblazed as a woman to be Chair and what advice she would give an up and coming student who wants to pursue academic medicine. This changed the tide of our interview and the tone. It was not going in a good direction as she was questioning my involvement in a minority based program and implying I was excluding those who were not of color. I told her, on the contrary, the organization I worked with was national and appealed to all students and those who had a passion for serving underserved populations. Just as I felt that this was not going well, I asked this when she asked – Do you have any questions for me?

This is key. You MUST come prepared with questions.This is paramount. I did this and it saved my residency interview. I also recommend that after you finish the interview, send a thank you letter by email or snail mail or both. In this letter to UCLA during my medical school application process, I stated unequivocally that UCLA was my first choice. Further, after I was waitlisted to the school, I emailed the Dean of Admissions in a last ditch effort plea to let him know that UCLA was where I felt I belonged and could contribute a diverse perspective to their student body as a woman of color that is from Los Angeles and who desires to serve the patient population locally. I didn’t think this would work and I don’t necessarily recommend that everyone try this approach as it is a real gamble. I did however a few weeks later, receive acceptance from UCLA off the waitlist. It was my first choice and I was elated.

I hope these tips help you in your interview season and beyond. Hit me up with questions via email or in the Forums. What questions do you have about the application process to medical school or residency?

Hey there. I want to address the next step in the medical journey after medical school – Residency. How do you get there? It’s called the NRMP Match. It’s a national program that matches medical students with residency programs. US, International Medical Grads and Osteopathic Medical students can apply. In short, students apply to programs, through NRMP, they are granted interviews, then afterwards they rank the programs in order of preference. Programs rank candidates in their incoming class. On Match Day, medical students nationwide find out where they complete their medical training all at the same time. Most students have a ceremony that commemorates this monumental occasion. It’s a day full of excitement and emotions. The picture above is of my graduating class in Anesthesiology at UCLA. I’m the one in the black and white dress. I was so excited to be graduating finally and starting a career. I was so fortunate to Match in 2008 as my first choice program.

What happens if you don’t match? Things have changed since my time, but now there is a secondary match called SOAP. Students can rank programs from various specialties and the secondary match will Match most students. For example, after about 30 k positions nationwide, after SOAP 2017, 101 spots remained unfilled.

In spite of these statistics, I encounter students from the US or IMG students who fail to match. How does this happen? Often time what hinders students from matching involves below average Step 1 score, any comments or disciplinary actions or needing to repeat portions of a medical school curriculum among other factors. For IMG, the reputation of their medical schools can be a barrier. Programs look more favorably on IMG candidates who have 1 year clinical experience, especially those who completed an internship in the US and are applying for PGY 2 positions.

Let’s go over some stats from the 2017 Match. The 2017 Match showed many US medical grads matched their top 3 choices but only 48% matched first choice. Also more IMG from US matched than ever before in terms of percentage (about 50%) but overall numbers were lower. The key is that they matched PGY1. For US IMG – You must get the internship. However the rates of matching into categorical Family of Internal Medicine (20% and 14 %) are higher than many PGY 1 only spots (about 6%). You could match a categorical IM spot then you can try to get a PGY 2 Position in your specialty of choice.

For anesthesiology, 74/1200 matched at US IMG. About 6% Chance. People faired much better matching internal medicine or Family. Internal Medicine, Surgery or Transitional PGY 1 are accepted by most anesthesiology programs, but as stated above these are competitive.

So what are the take home messages and what can you do to improve your chances of Matching?

1. Mentorship is key. You need mentors in your specialty of choice to give you a realistic view of whether you’d match and how to improve your chances. These faculty members can give you concrete numbers you need and look at your application. These usually are at your institution if in the US, or if an IMG, connecting with a US program director to meet with you and give you an honest opinion would be key. Ways to consider how to improve your application are research in the field, subinternships at reputable programs and letters from leaders in the field.

2. Having above board conduct and not too many academic red flags are important especially for competitive specialties. Programs do not want someone with ethics violations, problems following rules and order or those with academic problems. If you’ve had these, having additional research or clinical experience with people to vouch for you may help your situation. I found having 1 year of NIH research with pending publications greatly helped strengthen my application, and these programs are once in a lifetime opportunities. https://clinicalcenter.nih.gov/training/mrsp/

3. Audition rotations at programs of choice help. Most importantly performing well and forming relationship with leaders there help your case. If they remember you and like you, then you likely will match depending on specialty and competitiveness. This is general advice and every specialty has certain nuances to applying.

4. If you are an IMG, based on the numbers, it’s much easier to match Family or Categorical Internal Medicine. The key is to get your foot in the door. There are some IMG from US and outside who matched Anesthesiology. The rates were around 6-8% of applicants. These applicants likely were stellar in terms of their numbers. An above average and upper tier >235 Step Score is a must. If you are in the 218-234 range you have an uphill battle but it’s still possible. You must max out all applications in your specialty, all PGY 1 transitional, IM, Surgery and in my opinion apply for categorical IM and Family spots. The fact is specialties for US grads are competitive and more so for international grads.

I hope these tips help you all on your journey. Whether you are premed, first year medical student or are looking to Match, it’s good to know the process and ways to navigate it. IMG students don’t lose hope. This past year had a higher percentage of grads matching PGY 1 in a long time, and with some perseverance and strategic relationships you can navigate your way to success.

It’s been awhile and I’ve been working hard in both my personal and professional life. I’ve been doing research, talking to students, mentoring premeds and medical students. I am dedicating this post to some premed myths about admissions.

Premed Myths:

1. If I don’t have a perfect MCAT score or GPA then I won’t get into medical school. Similarly, if others don’t they don’t deserve to be there either.

This is patently false with a caveat. You need a strong GPA, whether in college, post bac (formal or informal) in upper division biological or hard sciences. This establishes ability to complete the rigors of science education in medical school. You also need a strong MCAT score: at least 70th percentile or above to get in the door. But we must remember you are more than just a score! Your preparation, your years of researching, volunteering, shadowing, community service etc. that demonstrate YOUR why for medicine are the things that give context to the store. The ad coms do not look at these numbers without the context of who you are, your story and your motivation. If those things are weak, numbers won’t help you. But- if you have a strong motivation for medicine that is demonstrated clearly through experiences and your grades and MCATs meet certain thresholds, then you could get the chance to convince the committee that you are a great candidate by gaining an interview.

As for others worthiness of being there – each person has a unique story. Don’t judge or look down on your fellow premeds. They will become your colleagues. You may need them one day.

2. Certain ethnicities or underrepresented minority groups have lower scores and unfairly get in to medical school.

I had to touch on this eventually because I clearly recall dealing with this as a premed on SDN (Student Doctor Network). I felt as if being African American, Latino or other minority was considered dirty, you were a cheater and you had to have a low GPA. You were seen as keeping all the worthy White and Asian students from getting into school. Some people said as much directly. This is patently false as well. If you have questions- I can attach the AAMC admissions numbers by race. The sad reality for African American students is that only about 1,500 got in 2017-2018. This is vs. 10,000 of majority students.

So it’s easy to blame the minority students for the fact hat some majority students didn’t get in- but the reality is that it couldn’t be. There’s just not that many getting in, and those that are have the scores. I know because I’ve seen it and have been on both sides as an applicant and as an attending physician. I make this argument because I want ALL students to know they are needed, wanted and worthy of this profession. In spite of current events and the state of our world, health care involves a diverse array of patients, who need a diverse array of physicians. Everyone is needed. Race and gender do not determine whether someone can achieve excellence. It’s sad I have to say these things in 2018 but it bears repeating. All of us can and will succeed if we put our minds to our goals. Instead of thinking of things as a zero sum game: you win, I lose – think more inclusive and synergistic. You can learn so much and a different perspective from working along side people different from you. I encourage all of us in this community to bounce ideas off each other and to use this as a safe space to be ourselves and to learn.

I hope these premed myths have been helpful. Next time, I’ll touch on some aspects of medical practice and what it’s like being on your own.

First, there is no such real thing as a premed major, but people usually mean majoring in Molecular Biology, Biochemistry and related degrees. While if you are at a four year institution this helps to streamline completed the medical school admissions requirements, it does not change the fact that you have to do them even if they aren’t included in your major. As such, there is no inherent advantage in having such a major. It helps to have something to differentiate you from the crowd. I recommend majoring in what you want to, what you will do well in, and doing your best in the prerequisites for medical school. This way, you are likely to have and keep a high GPA.

For non traditional students and those who attended community college prior to university, please see these as an advantage. Play up these diverse experiences in your personal statement and use the community college coursework to boost your GPA prior to transfer. This helps have a higher overall science GPA. If this is your situation, it may help to do more upper division sciences at a university to show you can handle the rigor of the coursework.

4.Your GPA and MCAT score must be perfect, or you will NEVER get into medical school.

This attitude was pervasive at UC Berkeley when I applied. I was told to my Face that I would NEVER get in to medical school with my GPA. They were right. This is why I took more upper division coursework, retool courses I did poorly in at a junior college and had a serious upward trend in my grades. This all occurred after I was able to stop working so much for a short period, as I had to support myself. Many students I know have the same situation. My advice is to take it slow, don’t take too many difficult courses at once, and focus to score highly to fix any GPA problems. That, coupled with a solid MCAT score of 75th percentile (508) and above, helps alleviate Committee concerns that an applicant can not handle the academic rigor of medical school.

If you are only a score then there would be no need for interviews. The fact is if you haven’t adequately explored your motivation for medicine or you haven’t demonstrated dedication through your activities, then your application is at a disadvantage no matter how high your grades are. Committee members can tell if you don’t quite have a solid idea of what you are pursuing. Don’t get them a reason to guess. Prepare yourself by doing free clinic work, overseas medical missions, shadowing, research with clinical focus and clinical exposure, health fairs etc. These are just a few ways to show you know what you are asking to do and why you are asking to do it.

I hope these two myth busters have been helpful. There are many more to come!!!!

Hello PREMEDS!!!! Application season is upon us. I saw a family friend and they asked me a series of questions that let me know many myths exist about being premed. I’m working to dispel a few. This is the purpose of this blog.

I will start with a few myths that are important to debunk.

1. You have to attend a college with a medical school to have a better chance at admission.

This is patently false. Admissions to medical school is competitive no matter where you attend for undergrad. Perhaps by some associations and premed societies you could meet medical school admissions staff and form connections. With some effort, this can be done regardless of your college of choice. I recommend attending a college that matches your interest and will give you the greatest number of options to explore not only sciences, but other subjects as well. There are combined colleges and medical school programs and these are limited and only few exist in the country. I recommend that a student really do their homework with shadowing physicians, being mentored and being certain of their career choice prior to embarking on something like this. Burnout is a reality and it takes a lot to commit to a path so early. For some though, these programs do prove to be the best choice.

2. If you have a high GPA as a high school student, this means you will get into medical school.

Achievement at the high school level sadly doesn’t always translate to the college level. Suddenly you go from the best in your class to the middle of the pack. Don’t despair. This is a normal phenomenon of college life. It takes perseverance and hard work to adjust to university life. It takes even more to pursue the path to medicine. You won’t be a shoe in because you have a 4.5 GPA now as a high school senior. It takes more than just grades to be ready for medical education and it takes a body of work, achievement and a demonstration that you’ve done your homework to know you really want this path.

Admissions committees see many applications. What will make yours stand out? How are you unique? These questions are important to consider when planning the activities you participate in, your shadowing or volunteer experiences and pursuing your passions and hobbies. All of these facets including the MCAT and your ability to effectively communicate these things in writing have an influence on your application.

These are just two myths that I’ve heard as of lately that I thought it important to address. In part two, I will address if you need to be a “premed” major to get into medical school and other myths about this process. My goal is to lay things out for you so you don’t have to sift through so much information out there. Please ask any questions you like, either here or in the forum.

Read this article featuring Medical Schools providing strong preparation for aspiring anesthesiologists that offer a third-year anesthesia rotation. I’m in agreement that UCLA did an extraordinary job on my third year rotation and especially sub internship with helping me get involved and understand that anesthesiology was my specialty of choice. Look for large teaching institutions that offer a wide variety of specialties and experiences including research. You never know what you will end up doing. I did not go into medical school planning to be an anesthesiologist, and I didn’t know I was headed in this direction. I am fortunate to have scored decently on Step 1 and to have met with the program directors and my sub internships to let them see what I knew and my interest and commitment to matriculating at UCLA for residency. These are some of the tactics I suggest for medical students.

For premeds, you don’t have to go to the same medical school as your residency. You could drastically change your mind a few times as I did. It’s generally a good idea though to have a variety of large institutions you apply to. If not, all you need to do is perform your personal best and do audition rotations where you’d like to go for residency or summer research. Seek out mentors at the places you are interested in. Research helps open the door for some, or a strong performance in audition rotations. Try your best to plan ahead medical students. Matching is becoming more competitive. Good luck everyone and check out the article.

My heart is heavy along with our nation in light of the recent suicides in our news. Anthony Bourdain, celebrity chef known for his transparency, his genuine love of people and food protrayed most recently on his CNN show “Parts Unknown”, was found this morning unconscious of an apparent suicide. Kate Spade, fashion icon and driven entrepreneur was found earlier this week. The CDC recent report shows that suicide rates are skyrocketing. Depression is a common disorder, and we all feel some psychological pain at times. These things happen more than we care to talk about, to friends, loved ones, moms, dads and children.

I write this blog to help students at all phases of their medical journey to understand they are not alone. For everyone who feels lonely, isolated, like a failure or that they are just tired of how their life is playing out – you are not alone. I’ve been there, and everyone at some point had felt these emotions. To feel them is human. It plain sucks to be on call, try to save someone and fail, comfort grieving families or see people suffer over and over again. As physicians we take, take, take and do not reach out for help. Yet we know that we need others to just hear us out, sometimes we need a neutral party to let it out! The pressure of life, personal or professional sometimes can eat us up and most times people simply internalize these feelings vs reaching out.

I’m encouraging you- if you read my blog and you feel disillusioned, depressed about your progress and your journey, please reach out to me or to someone just to talk. I’ve been a premed, a medical student, a resident, a fellow and now I’m an attending and walking out that journey. I was a non traditional student. I’m from a group underrepresented in medicine. I know what it is to feel out of place, and I’ve learned to work through a medical system that can be so difficult at times. I’m here to listen, commiserate and answer your questions regarding the medical journey, life as a physician and what is takes to be successful. I can be reached at premedconsultants@gmail.com. My aim is to be a sounding board and to let you know you are not alone. Of course our conversations are confidential.

If you are in crisis please call 911. If you need to speak to someone, you feel depressed and need a listening ear, please call